Percutaneous techniques for aneurysm repair

Preoperative hypofibrinogenemia is associated with increased intraoperative bleeding in ruptured abdominal aortic aneurysms

“…The femoral access sites are the main concern for bleeding and previous studies have investigated perioperative bleeding related to closure devices and other methods of access site closure. [4][5][6][7] The purpose of this thesis has been to investigate key components of bleeding in AAA repair. The four scientific papers investigate practical issues, risk factors, and predictors of bleeding as well as the treatment of bleeding associated with both non-ruptured and ruptured AAA in open and endovascular repair.…”

Clinical Practice Guidelines for Endovascular Abdominal Aortic Aneurysm Repair: Written by the Standards of Practice Committee for the Society of Interventional Radiology and Endorsed by the Cardiovascular and Interventional Radiological Society of Europe and the Canadian Interventional Radiology Association

“…Calcification Ͼ 50% of circumference; atheroma or thrombus (Ͼ 2 mm thick) Ͼ 50% of circumference (80,81,84), such late complications were nonexistent after percutaneous treatment. Totally percutaneous aneurysm repair requires good patient selection, technical expertise, and a thorough understanding of the device (84) and should be performed in a sterile environment or where open arterial access can be obtained rapidly if required.…”

Tratamento de Aneurisma da Aorta Abdominal por PEVAR Complicado de Pseudo-Aneurisma Femoral

“…2,3 Classicamente, a realização deste tipo de implantes requeria a total exposição cirúrgica da artéria femoral (por norma, bilateralmente), tendo em vista garantir uma correta manipulação do material a implantar durante o procedimento e hemostase adequada no final do mesmo. 4 Embora acarretem baixo risco cirúrgico para o doente, este tipo de exposições não estão desprovidas de riscos, com complicações locais descritas em 14-22% dos casos, as quais, inevitavelmente, constituem causa de maior morbilidade para o doente e taxa de reinternamento mais elevada neste grupo populacional tipicamente tão frágil. 5,6 Tendo em vista minorar estas complicações de acesso, Haas et al descreveram em 1999 e pela primeira vez o EVAR com acesso por via percutânea (pEVAR).…”